Untitled record

Application filed November 21,1888. Serial No. 291,436, (No model.)

To all whom it may concern:

Be it known that I, Alexander Steinhoff, of Briesnitz, near Dresden, Kingdom of Saxony, German Empire, doctor of medicine, 5 have invented certain new and useful Improvements in Apparatus for Treating Emphysema, of which the following is a specification.

The present invention consists in an appaio ratus for treating emphysema, in which apparatus, besides those parts usually employed for such treatment—as, for instance, an airaccumulator and an inhalation mouth-piece or mask connected together by pipes or tubes— 15 an expansible air-vessel is made use of, said air-vessel being arranged or introduced between the air-accumulator and the mouthpiece. This expansible air-vessel, while being put alternately in communication with 20 the accumulator and with the mouth-piece, has for its object to act by expansion against the chest or thorax of the patient when said vessel receives the charge of compressed air from the accumulator, if connected with the lat25 ter, whereas if connected with the mouthpiece it discharges its compressed air for inhalation. In such alternate action of the expansible air-vessel the change of its communication with the accumulator or with the mouth-piece 30 is not performed by any special labor of the patient, said change being produced automatically by alternating electrical connection of the valve in the mouth-piece with two valves, of which one is arranged in the pipe-connec35 tion between the accumulator and the expansible air-vessel, the other being arranged in the pipe-connection between the expansible airvessel and the mouth-piece. The expansible ‘ air-vessel, which I preferably name a “breath40 ing-belt,” produces in an automatical manner by its expansion a compression of the thorax during the exhalation period, thereby essentially assisting the treatment of emphysema by compressed air.

In Figure 1 of the annexed drawings I have shown the arrangement of the complete apparatus during employment of same, whereas Fig. 2 shows a separate view of the valves in their electrical connection with the mouth50 piece or mask and the source of electricity.

Fig. 3 is a vertical section, and Fig. 4 is a sectional plan, of the valve-box. I

The air, which, if necessary, may be mixed with any medical substances, is forced by any of the known devices—such as pumps, bellows, 5 5 &c., worked by water - pressure, motor, or treadle, &c.—into the accumulator, which, according to the pressure with which the air is to issue from it, may be loaded by weights.

The air from the accumulator is conducted 60 first into the valve-box B, (which will hereinafter be described in detail,) and from here into the breathing’-belt C. This breathingbelt C consists mainly of an expansible vessel of such form that it may readily be placed 65 on or against the thorax of the patient, and preferably on or against the lower part of the thorax. The expansible vessel is kept in this position by belts or straps over the shoulders of the patient, crossing on the back, and be- 70 ing buttoned to straps or belts, which, coming from the ends of the expansible vessel, are united by a buckle or otherwise at the back of the patient.

.. That Avail of the hollow breathing-belt which 75 is averted from the body of the patient is made of a less expansible material, whereas the wall of said breathing-belt next the body of the patient is of a more expansible material, so that if compressed air is admitted into 80 the breathing-belt it will expand toward the thorax and will compress the latter by such expansion.

The breathing-belt may be made, preferably, of a properly-formed sack of vulcan- 85 ized caoutchouc or other suitable material. In order to make the outer wall away from the patient less expansible, it may either be made of thicker material or be covered on this side by some non-expansible fabric. If, 90 now, this outer wall or covering-fabric is provided at its side ends by belts or straps buckled at the back of the patient, as above stated, the expansion of the breathing-belt, if compressed air is admitted, must take place toward the 95 thorax.

From the breathing-belt a pipe conducts the air into the valve-box D, and from the latter into the mouth-piece of the inhalationmask., The mask may be suitably made of a 100 wire, framing, the wires being covered with cloth, and the whole mask being covered by some flexible material.

From the foregoing description the manner

403,779 of using the apparatus composed as described is readily understood, if it is taken into consideration that during the period in which, the patient inhales or breathes the valve in 5 the box B is closed and the valve in the box D is opened, whereas during· the exhalation period the valve in B is opened, while the valve in D is closed. By this alternate play of valves inhalation of compressed air issu;o ing from the breathing-belt takes place, and during exhalation through the nose the breathing-belt is charged with compressed air from the accumulator, by which filling process the breathing-belt exerts by its expansion a com15 pression of the thorax.

The play of the valves in the boxes B and D is effected by an electric current from the element or battery E, or from any other convenient source of electricity, in the following 20 manner: As indicated in Fig. 2, the pipe or tube a terminates in the inhalation-mask a', within which is a flap-valve, b, which by its standing position is kept close, and which flap-valve will readily open by inhalation or 25 breathing of the patient. This flap-valve is capable of conducting an electric current, and it is connected by the wire c with the element or battery E, whereas the contact d, projecting from the lower end of the flap-valve b, is 3c arranged between the two contact ends of the wires e and f. The wire e is at its other end connected to the coil of an electro-magnet in the valve-box D, from where a returnwire, g, leads to the battery E. The wire f is 35 at its other end connected to the coil of an electro-magnet in the valve-box B, from where a return-wire, It, leads also to the battery E.

The construction of the valve-box B is shown in detail in Fig. 3, which is a vertical section, 40 and Fig. 4 a horizontal section.

B' is an electro-magnet connected with the conducting-wire f and the return-wire h.

B⁵ is the flap-valve, arranged as an armature to the electro-magnet B', which arma45 ture is attracted by B' as soon as the current flows through the coils or bobbins of the electro-magnet By such attraction the air-inlet pipe is closed. As soon as the current ceases by interruptions, the flap-valve B*⁵ will be with50 drawn from the electro-magnet by means of the spring B², thereby opening the air-inlet and allowing the current of compressed air to rush through the valve-box in the direction of the arrows.

The valve-box I) is of same construction as B, the electro-magnet in this case being connected to the wires e and g.

Now, returning to Fig. 2, it will be seen that if the flap-valve b is in its closed posi60 tion, (that is to say, during the patient’s exhalation through the nose,) the electric current from the battery E goes through wire c, flap b, contact d, wire e, to valve I), keeping the latter closed, so that at this period no 65 compressed air is admitted from the breathing-belt Cinto the inhalation-mask. During this period the contact d is not in connection with the wire f, and therefore no electric current communicated to valve B, this latter being opened by its spring, and compressed air 70 is admitted from the accumulator A into the breathing-belt C, this belt being expanded and pressed against the thorax. As soon as the inhalation period of the patient commences he will, by the effect of the inhala- 7 5 tion, raise the flap-valve b, thus immediately interrupting the current-connection with the valve D, -which now opens under the influence of its spring and allows the compressed air to rush from the belt C into the mouth-piece 80 of the mask. As at the same time the flapvalve b has brought its contact d against the wire f, the electric current goes from E through wire c, flap-valve b, contact d, and wire f to valve B, where the electric current 85 will cause this valve to close, thereby interrupting the admission of air from A to C. The play of these valves B and D is, as is now readily understood, caused by the alternate contact of the flap-valve b with the ends 90 of the wire e and f, so that the admission of compressed air into the breathing-belt C is interrupted when this latter discharges its contents of compressed air by the valve D into the mouth-piece of the mask, while the ad- 95 mission of compressed air into the belt C from the accumulator A through valve B takes place during the exhalation period of the patient, said admission of compressed air into the breathing-belt C causing the latter 100 to expand and to press against the thorax during the exhalation period of the patient, which pressure will greatly facilitate the exhalation process of the patient.

The alternate closing of the valves B and 105 D maybe effected by the action of the springs and opened by the electro-magnet. If in. the apparatus specified a device for compressing air is employed which is capable of delivering a current of air of uniform and steady no pressure, the accumulator A may be dispensed with, and the piping from the aircompressing device may be directly fitted to the box of the valve B. However, the use of an accumulator like A may be preferred for 115 insuring of uniform operation and steady pressure of air.